Claims outcome not to your satisfaction? Here's how you can escalate your concern.
We know any medical emergency can be taxing, but we want this process to be as smooth as possible.
We make all claims decisions based on the information we receive. We will review any new information we might receive after having made our decision. If you believe our decision is incorrect based on the evidence we find, you may appeal.
To appeal a decision, or make a general inquiry about the decision, please contact Allianz Global Assistance using the contact information on the claims decision letter you received. Please note that if you wish to appeal, you must submit this in writing with any new supporting documentation.
Contact the Ombuds Office
Should your claim still remain unresolved following the appeals process, you may request additional consideration of your concern in writing to the relevant Ombuds Office. Please note that the Ombuds Office will only review concerns that have gone through the appropriate steps above so you will want to indicate who you have already spoken with:
For products underwritten by CUMIS General Insurance Company or Co-operators Life Insurance Company:
By mail: Ombudsperson
c/o Co-operators Life Insurance Company
130 Macdonell Street
Guelph, Ontario N1H 6P8
For products underwritten by Allianz Global Risks US Insurance Company (Canadian Branch):
By mail: Ombudsperson
Allianz Global Risk US Insurance Company (Canadian Branch)
1600-130 Adelaide Street West
Toronto, ON, Canada M5H 3P5
After the Ombuds Office’s review, you will receive a written response, except in the case where a simple concern can be cleared up over the phone. Most investigations are completed within 30 business days of receiving your complaint and all supporting documentation. If this deadline cannot be met, you will be contacted as to why extra time is required and when you can expect a response.
The written response from the Ombuds Office is considered the company’s final position. Unless you present any new and relevant information that was not previously reviewed, your concern will not be reopened.
External Recourse Options
If we have not been able to resolve your concerns to your satisfaction and you wish to pursue the matter further, you may contact the General Insurance OmbudService (GIO). GIO is an independent service that offers recourse to consumers who have not been able to resolve their complaint by dealing with their insurance company. The OmbudService can be reached at 1-877-225-0446 or through their website at www.giocanada.org
Note: You must follow the Company’s Complaint Resolution Process (described above) before GIO will become involved.
For Quebec clients;
if you are not satisfied with how your concern was handled, or the results of our investigation, the law gives you the right to request, in writing, that a copy of your file be transferred to the Authorité des marches financiers (AMF). You can reach the AMF by calling 1-877-525-0337 or by email at: firstname.lastname@example.org
The Financial Consumer Agency of Canada
The Financial Consumer Agency of Canada (FCAC) provides consumers with accurate and objective information about financial products and services, and informs Canadians of their rights and responsibilities when dealing with financial institutions. FCAC also ensures compliance with the federal consumer protection laws that apply to banks and federally incorporated trust, loan and insurance companies.